Levosimendan in veno‐arterial extracorporeal membrane oxygenator supported patients: Impact on the success of weaning and survival
Autor: | Soraya Merchán-Gómez, Alejandro Diego-Nieto, Pedro L. Sánchez, Elisabete Alzola, Marta Alonso-Fernández-Gatta, Miryam Gonzalez-Cebrian, Ines Toranzo-Nieto, Francisco Martín-Herrero, Alfredo Barrio |
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Rok vydání: | 2021 |
Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Cardiotonic Agents medicine.medical_treatment 0206 medical engineering Shock Cardiogenic Biomedical Engineering Medicine (miscellaneous) Bioengineering 02 engineering and technology 030204 cardiovascular system & hematology Biomaterials 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Internal medicine medicine Extracorporeal membrane oxygenation Humans Weaning Simendan Retrospective Studies Ejection fraction business.industry Cardiogenic shock Mortality rate General Medicine Levosimendan Middle Aged medicine.disease 020601 biomedical engineering surgical procedures operative Case-Control Studies Shock (circulatory) Cardiology Female medicine.symptom business medicine.drug |
Zdroj: | Artificial Organs. 45:717-725 |
ISSN: | 1525-1594 0160-564X |
Popis: | Weaning failure and mortality rates in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) supported patients are significant. Small studies suggest the possible usefulness of levosimendan in this environment, especially in postcardiotomy shock. We performed a retrospective analysis of VA-ECMO implants in a referral hospital comparing weaning failure and survival of patients treated with levosimendan with a control group. From 2013 to May 2020, 123 VA-ECMO for several indications were implanted. Levosimendan was administered in 23 patients (18.7%) with good tolerance. Levosimendan was used more frequently in cardiogenic shock due to acute coronary syndrome indication, and in patients with lower left ventricular ejection fraction (LVEF) at the implant. No significant differences were found in success of ECMO weaning (60.9% levosimendan group vs. 44% non-levosimendan group, P = .169) despite worse LVEF in levosimendan group. Survival at follow-up (20.6 [58] months) was higher in the group that received levosimendan, although without finding statistically significant differences (47.8% vs. 32.0%, log rank P = .124). Levosimendan can be safely administered during VA-ECMO support. Patients receiving levosimendan were weaned similarly from circulatory support despite worse LVEF. Its use did not influence in short- and medium-term survival. Randomized studies are needed to evaluate the levosimendan impact in this indication. |
Databáze: | OpenAIRE |
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